{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:01:03Z","timestamp":1780408863346,"version":"3.54.1"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Upper limb disorders, including carpal tunnel syndrome (CTS), are a common cause of pain, functional limitations, and reduced quality of life. Increasing attention has been directed toward the role of inflammatory and angiogenic mediators in the pathophysiology of CTS and their potential relationship with patient-reported functional outcomes. The aim of this study was to evaluate selected cytokines as potential markers of upper limb disability assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. This cross-sectional study included 55 patients with idiopathic CTS referred for surgical treatment. Functional impairment was assessed using the DASH questionnaire, and concentrations of selected inflammatory and angiogenic mediators\u2014IL-4, IL-6, MCP-1, TNF-\u03b1, VEGF, and fraktalkine\u2014were measured in synovial tissue samples; these markers were selected based on their established roles in inflammation, angiogenesis, and nociceptive modulation relevant to CTS pathophysiology. VEGF was identified as a significant predictor of DASH category (p = 0.032), with higher concentrations associated with a lower likelihood of severe upper limb dysfunction. In contrast, higher TNF-\u03b1 levels were associated with an increased risk of severe disability (p = 0.031). Other cytokines did not demonstrate significant associations with functional impairment. These findings suggest that selected inflammatory and angiogenic mediators were associated with the severity of functional disability in CTS and warrant investigation in prospective longitudinal studies to clarify their potential role alongside patient-reported outcome measures.<\/jats:p>","DOI":"10.3390\/ijms27114975","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:45:08Z","timestamp":1780404308000},"page":"4975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Divergent Roles of VEGF and TNF-\u03b1 in Functional Impairment Among Patients with Carpal Tunnel Syndrome"],"prefix":"10.3390","volume":"27","author":[{"given":"Ireneusz","family":"Walaszek","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Schneider-Matyka","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2279-4329","authenticated-orcid":false,"given":"Mateusz","family":"Bosiacki","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-0564","authenticated-orcid":false,"given":"Szymon","family":"Grochans","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Oncological Surgery, Urology and Hand Surgery, Faculty of Medicine, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaja","family":"Gi\u017cewska-Kacprzak","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Oncological Surgery, Urology and Hand Surgery, Faculty of Medicine, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3679-7002","authenticated-orcid":false,"given":"El\u017cbieta","family":"Grochans","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1830-2114","authenticated-orcid":false,"given":"Mariusz","family":"Panczyk","sequence":"additional","affiliation":[{"name":"Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6912-287X","authenticated-orcid":false,"given":"Anna Maria","family":"Cybulska","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-7783","authenticated-orcid":false,"given":"Patrycja","family":"Kapczuk","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2200-3766","authenticated-orcid":false,"given":"Kamila","family":"Rachubi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1515\/jbcpp-2024-0004","article-title":"Exploring pathogenic pathways in carpal tunnel syndrome: Sterile inflammation and oxidative stress","volume":"35","author":"Arshad","year":"2024","journal-title":"J. Basic Clin. Physiol. Pharmacol."},{"key":"ref_2","first-page":"58","article-title":"Level of functional impairment using symptom severity and functional status scales in patients with carpal tunnel syndrome","volume":"1","author":"Zafar","year":"2021","journal-title":"Heal. J. Physiother. Rehabil. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"156777","DOI":"10.1016\/j.cyto.2024.156777","article-title":"Inflammatory cytokines and carpal tunnel syndrome: A causal relationship revealed","volume":"184","author":"Yang","year":"2024","journal-title":"Cytokine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s00420-010-0605-4","article-title":"Functional impairment in video terminal operators is related to low-grade inflammation","volume":"84","author":"Riondino","year":"2011","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"B\u0103cil\u0103, C., Vl\u0103doiu, M.-G., Valeanu, M., Moga, D., and Pumnea, P.-M. (2025). The role of IL-6 and TNF-\u03b1 biomarkers in predicting disability outcomes in acute ischemic stroke patients. Life, 15.","DOI":"10.3390\/life15010047"},{"key":"ref_6","first-page":"9721","article-title":"Relationship of immune cells with disability and cognitive impairment in NMOSD","volume":"27","author":"Li","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1080\/00207454.2020.1737050","article-title":"Serum levels of inflammatory cytokines in patients with idiopathic carpal tunnel syndrome","volume":"131","author":"Karimi","year":"2020","journal-title":"Int. J. Neurosci."},{"key":"ref_8","first-page":"526","article-title":"Systemic inflammatory markers in neuropathic pain, nerve injury and recovery","volume":"163","author":"Bennett","year":"2021","journal-title":"Pain"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"484.e1","DOI":"10.1016\/j.jhsa.2017.10.031","article-title":"Psychological status is associated with symptom severity in patients with carpal tunnel syndrome","volume":"43","author":"Shin","year":"2018","journal-title":"J. Hand Surg."},{"key":"ref_10","first-page":"2422","article-title":"Which psychological and electrodiagnostic factors are associated with limb disability in patients with carpal tunnel syndrome?","volume":"479","author":"Daliri","year":"2021","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_11","first-page":"567","article-title":"The long-term effect of neurodynamics vs exercise therapy on pain and function in CTS: Randomised parallel-group trial","volume":"33","author":"Hamzeh","year":"2020","journal-title":"J. Hand Ther."},{"key":"ref_12","first-page":"198","article-title":"Physiotherapy plus acupuncture vs physiotherapy alone in CTS: Randomised clinical trial","volume":"35","author":"Mamipour","year":"2023","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_13","first-page":"80","article-title":"Manual therapy improves symptom severity and disability in CTS","volume":"22","author":"Pogorzelski","year":"2022","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_14","first-page":"4655","article-title":"Effects of mirror therapy on pain, sensitivity and functionality in unilateral CTS: Randomised controlled trial","volume":"46","year":"2023","journal-title":"Disabil. Rehabil."},{"key":"ref_15","first-page":"88","article-title":"Comparing endoscopic and conventional surgery techniques for CTS: Retrospective study","volume":"40","author":"Donati","year":"2024","journal-title":"JPRAS Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"511","DOI":"10.2147\/TCRM.S514225","article-title":"Device-assisted mini-incision versus conventional carpal tunnel release: Retrospective cohort of 109 cases","volume":"21","author":"Guo","year":"2025","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.17712\/1658-3183.2112","article-title":"Pathophysiology of carpal tunnel syndrome","volume":"20","author":"Aboonq","year":"2015","journal-title":"Neurosciences"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8218","DOI":"10.1038\/s41598-017-08123-6","article-title":"Immune dysregulation in patients with carpal tunnel syndrome","volume":"7","author":"Baharuddin","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1002\/path.1673","article-title":"The relationship of VEGF and PGE2 expression to extracellular matrix remodelling of the tenosynovium in carpal tunnel syndrome","volume":"204","author":"Hirata","year":"2004","journal-title":"J. Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zimmerman, M., Gotts\u00e4ter, A., and Dahlin, L.B. (2022). Carpal tunnel syndrome and diabetes\u2014A comprehensive review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11061674"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e2114406119","DOI":"10.1073\/pnas.2114406119","article-title":"Pathogenic TNF-\u03b1 drives peripheral nerve inflammation in an Aire-deficient model of autoimmunity","volume":"119","author":"Wang","year":"2022","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bari\u010di\u0107, M., Cvijanovi\u0107 Peloza, O., Jerbi\u0107 Radeti\u0107, A.T., \u0160anti\u0107, V., Omr\u010den, H., and Zori\u010di\u0107 Cvek, S. (2023). Serum levels of inflammatory and fibrotic cytokines in patients with carpal tunnel syndrome and hip osteoarthritis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11010011"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lauro, C., Catalano, M., Di Paolo, E., Chece, G., De Costanzo, I., Trettel, F., and Limatola, C. (2015). Fractalkine\/CX3CL1 engages different neuroprotective responses upon selective glutamate receptor overactivation. Front. Cell. Neurosci., 8.","DOI":"10.3389\/fncel.2014.00472"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1525-1594.1994.tb02227.x","article-title":"Serum hyaluronic acid and interleukin-6 as possible markers of carpal tunnel syndrome in chronic haemodialysis patients","volume":"18","author":"Takasu","year":"1994","journal-title":"Artif. Organs"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"387","DOI":"10.5604\/15093492.1119616","article-title":"Translation and cultural adaptation of the Polish versions of the Disabilities of the Arm, Shoulder and Hand (DASH) and QuickDASH questionnaires","volume":"16","author":"Golicki","year":"2014","journal-title":"Ortop. Traumatol. Rehabil."},{"key":"ref_26","first-page":"169","article-title":"The Box\u2013Cox transformation technique: A review","volume":"41","author":"Sakia","year":"1992","journal-title":"J. R. Stat. Soc. Ser. D."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cohen, J., Cohen, P., West, S.G., and Aiken, L.S. (2013). Applied Multiple Regression\/Correlation Analysis for the Behavioral Sciences, Routledge. [3rd ed.].","DOI":"10.4324\/9780203774441"},{"key":"ref_28","first-page":"412","article-title":"Measures of effect size for chi-squared and likelihood-ratio goodness-of-fit tests","volume":"103","author":"Johnston","year":"2006","journal-title":"Percept. Mot. Ski."},{"key":"ref_29","unstructured":"Agresti, A. (2013). Categorical Data Analysis, Wiley. [3rd ed.]."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/11\/4975\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:02:11Z","timestamp":1780405331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/11\/4975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,30]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["ijms27114975"],"URL":"https:\/\/doi.org\/10.3390\/ijms27114975","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,30]]}}}